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PART 24

When the fevers cease without any symptoms of resolution occurring,
and not on the critical days, in such cases a relapse may be anticipated.
When any of the fevers is protracted, although the man exhibits symptoms
of recovery, and there is no longer pain from any inflammation, nor
from any other visible cause, in such a case a deposit, with swelling
and pain, may be expected in some one of the joints, and not improbably
in those below. Such deposits occur more readily and in less time
to persons under thirty years of age; and one should immediately suspect
the formation of such a deposit, if the fever be protracted beyond
twenty days; but to aged persons these less seldom happen, and not
until the fever be much longer protracted. Such a deposit may be expected,
when the fever is of a continual type, and that it will pass into
a quartan, if it become intermittent, and its paroxysms come on in
an irregular manner, and if in this form it approach autumn. As deposits
form most readily in persons below thirty years of age, so quartans
most commonly occur to persons beyond that age. It is proper to know
that deposits occur most readily in winter, that then they are most
protracted, but are less given to return. Whoever, in a fever that
is not of a fatal character, says that he has pain in his head, and
that something dark appears to be before his eyes, and that he has
pain at the stomach, will be seized with vomiting of bile; but if
rigor also attack him, and the inferior parts of the hypochondrium
are cold, vomiting is still nearer at hand; and if he eat or drink
anything at such a season, it will be quickly vomited. In these cases,
when the pain commences on the first day, they are particularly oppressed
on the fourth and the fifth; and they are relieved on the seventh,
but the greater part of them begin to have pain on the third day,
and are most especially tossed on the fifth, but are relieved on the
ninth or eleventh; but in those who begin to have pains on the fifth
day, and other matters proceed properly with them, the disease comes
to a crisis on the fourteenth day. But when in such a fever persons
affected with headache, instead of having a dark appearance before
their eyes, have dimness of vision, or flashes of light appear before
their eyes, and instead of pain at the pit of the stomach, they have
in their hypochondrium a fullness stretching either to the right or
left side, without either pain or inflammation, a hemorrhage from
the nose is to be expected in such a case, rather than a vomiting.
But it is in young persons particularly that the hemorrhage is to
be expected, for in persons beyond the age of thirty-five, vomitings
are rather to be anticipated. Convulsions occur to children if acute
fever be present, and the belly be they cannot sleep, are agitated,
and moan, and change color, and become green, livid, or ruddy. These
complaints occur most readily to children which are very young up
to their seventh year; older children and adults are not equally liable
to be seized with convulsions in fevers, unless some of the strongest
and worst symptoms precede, such as those which occur in frenzy. One
must judge of children as of others, which will die and which recover,
from the whole of the symptoms, as they have been[p. 59] specially described.1
These things I say respecting acute diseases, and the affections which
spring from them.

1 Our author here and elsewhere impresses it upon his readers that it is from the tout ensemble of the symptoms that a judgment is to be formed in every case. This is evidently a remark of the most vital importance in forming a prognosis.

The Genuine Works of Hippocrates. Hippocrates. Charles Darwin Adams. New York. Dover. 1868.

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